The Health Issue You Must Discuss

Heart disease is the #1 killer of women, yet talking about it isn't always easy. Find out what's behind the hesitation and how you can help get the word out.

By
Barbara Brody

Jul 8, 2015

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When Sandy Musacchio first learned that she had heart disease nine years ago, she kept it a secret. "I was uncomfortable sharing with anyone because I had a hard time accepting it myself," she says. "I thought I was a healthy 40-year-old, and I believed heart disease was something that happened to overweight old men."

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Sandy eventually came to terms with her condition, a lipid disorder that makes her prone to clogged arteries. She now works with the national organization WomenHeart and leads a support group near her home in Oregon, WI.

But her initial reaction to keep quiet about it isn't unusual: More than 75% of women ages 25 to 60 rarely or never discuss heart disease with family and friends, according to a survey of more than 1,000 women commissioned by the Women's Heart Alliance. And 26% of respondents agreed that "having problems with your heart is embarrassing—people just assume you are not eating right or exercising."

These numbers are alarming because heart disease is the top health threat for women (more so than all cancers combined) and breaking the silence is crucial to changing the statistic.

There used to be a time when the word cancer was spoken in hushed tones. Fortunately that's changed, and many women are now comfortable talking about breast cancer—yet heart disease still seems taboo, says Sharonne Hayes, MD, founder of the Mayo Clinic Women's Heart Clinic in Rochester, MN.

Eighty percent of heart disease is preventable, says Stacey Rosen, MD, cardiologist and vice president for women's health at North Shore-LIJ Health System in New York. But that means 20% of it is not, and it's women who tend to blame themselves, regardless of whether they actually had controllable risk factors. Sandy sees this firsthand. "So many women are reluctant to talk about their diagnosis because they're overweight or work too much," she says. And even though Sandy did everything "right"—she exercised and was at a normal weight—she still criticized herself.

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Meanwhile, other people's questions only made her feel worse. Shortly before Sandy's diagnosis, her 39-year-old sister, Susie, had a heart attack and died. Well-wishers expressed concern—yet they tried to figure out what Sandy and Susie had done "wrong." They wanted to know if the sisters ate a lot of meat, exercised too little or were stressed.

Sandy with her daughter, Sophia

Sandra Musacchio

A dangerous silence

The notion that heart disease is your own fault may actually prevent women from even broaching the topic with their doctors. Many report that they delay going to a healthcare provider because they mistakenly think they should lose some weight first, says C. Noel Bairey Merz, MD, director of the Barbra Streisand Women's Heart Center at Cedars-Sinai Heart Institute in Los Angeles. And this reluctance to talk about heart disease may in part explain why there are still major knowledge gaps.

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For one, female heart attack symptoms are sometimes different from what men experience. Nausea, sweating and shortness of breath are common for women. If you've only heard about the classic "Hollywood heart attack" (clutching your chest and falling to the ground), you might not realize you're in danger.

Even if you do suspect something is amiss, you may be slow to action. New research from the Yale School of Public Health found that women ages 30 to 55 are especially prone to ignoring the warning signs, which might be a reason they're much more likely to die of heart disease compared with men of the same age. (Under 50, a woman's heart attack is twice as likely to be fatal as a man's.)

When a woman does go to the ER, she's apt to hem and haw, says Dr. Rosen. "Some will be in the waiting room and say, 'Take him first. Don't worry about me.'" Yet one woman dies of heart disease approximately every minute.

"You need to go in and yell, 'I'm having a heart attack!'" says Dr. Rosen. "You're better off being wrong and laughing about it later."

Shifting course

The good news is that there's a lot you can do to help turn the tide. To start, most women should get their risk factors evaluated on a regular basis, starting at age 20. Beyond that, heed this advice:

If you know someone with heart disease… When a friend or loved one shares her heart-health struggle, be supportive. Make it a point to avoid asking the "what did you do" kinds of questions.

If you're recently diagnosed…Try to stop the self-blame, regardless of your risk factors. Being hard on yourself can make you anxious and interfere with treatment, making you less likely to go to cardiac rehab, take your medication or stay in touch with your doctors. Connecting with other survivors can help change your mindset. (Ask your hospital if there's a support group available.)

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If you're a survivor… It's time to be loud and proud about sharing your story. If you're ready to take that step but worried about others pointing fingers, prepare yourself with a smart response. "My go-to answer is to say that all women are at risk for heart disease and there's no simple, quick fix," says Sandy. And remember: Speaking up encourages others who might otherwise ignore heart health to pay attention. "I recently spoke at a luncheon, and one woman told me she called her doctor's office during dessert and made an appointment to discuss her heart concerns," says Sandy. "That's exactly why I share my story with strangers—the more we all talk, the more lives we'll save."

4 surprising things that can harm your heart

These risk factors aren't related to weight or habits, but they can take a toll on your ticker.

1. Migraines with aura Women who suffer from severe headaches accompanied by flashes of light or odd smells have an increased risk of stroke.

2. Autoimmune disorders These conditions—which include rheumatoid arthritis and lupus—trigger inflammation and can raise your odds of heart issues.

3. Early menopause Research shows that experiencing the change before age 46 may make you twice as likely to suffer from coronary heart disease (hardening of the arteries).

4. Depression Female heart attack survivors who are depressed are more likely to have a second episode.

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